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Previous issue date: 2016-05-13 === Introdu??o: A promo??o de uma Cultura de Seguran?a do Paciente (CSP) nas organiza??es de sa?de tem sido recomendada como uma pr?tica que contribui para a redu??o do risco de danos desnecess?rios associados ao cuidado de sa?de, por?m n?o h? evid?ncias das interven??es em sa?de p?blica que devem ser implantadas. O sistema de sa?de brasileiro regulou uma s?rie de medidas para este objetivo, por?m sua efetividade ainda n?o foi avaliada. Objetivo: Analisar o efeito do Programa Nacional de Seguran?a do Paciente (PNSP) na Cultura de Seguran?a do Paciente. M?todo: Trata-se de um delineamento quase-experimental com abordagem descritivo-anal?tica. A CSP foi avaliada em tr?s hospitais com diferentes perfis, tr?s meses antes (n=215) e quinze meses ap?s (n=450) a implanta??o do programa nacional de seguran?a do paciente. Utilizou-se um instrumento validado e adaptado ? realidade brasileira (Hospital Survey On Patient Safety Culture). A evolu??o da CSP foi avaliada por meio de 14 indicadores simples e 2 compostos. Resultados: A CSP teve evolu??o positiva de forma consistente ap?s a implementa??o do PNSP. Os hospitais melhoraram a CSP em 14 dos 16 indicadores avaliados, que incluem 11 das 12 dimens?es avaliadas, a Porcentagem de Respostas Positivas total, a m?dia da nota para a seguran?a do paciente e o ?ndice de CSP. O hospital que apresentou maior melhoria foi o estadual seguido do federal e privado, isto demonstra que o PNSP foi um indutor da homogeneiza??o dos servi?os prestados no Brasil, pois esta ordem era inversa do n?vel de cultura antes do PNSP. Conclus?o: O estudo evidencia uma melhoria consistente da CSP em hospitais ap?s o PNSP, apontando para a efetividade da regula??o nacional externa, que por sua vez aparentam ser moduladas pela variabilidade do contexto interno. === Introdution: Promoting Patient Safety Culture (CSP) in health organizations has been recommended as a practice that contributes to reducing the risk of unnecessary harm associated with health care, but there is no evidence of public health interventions They should be deployed. The Brazilian health system has regulated a series of measures for this purpose, but its effectiveness has not been evaluated. Objective: To analyze the effect of Patient Safety National Program (PNSP) on Patient Safety Culture. Method: This is a longitudinal quase-exprimental design with descriptive and analytical approach. The CSP was evaluated in three hospitals with different profiles, three months before (n = 215) and fifteen months (n = 450) the implementation of national patient safety program. We used a validated instrument and adapted to the Brazilian reality (Hospital Survey On Patient Safety Culture). The development of CSP was evaluated by simple indicators 14 and 2 compounds. Results: The CSP had positive developments consistently following the implementation of PNSP. Hospitals improved CSP in 14 of the 16 indicators assessed, including 11 of the 12 dimensions evaluated, the total Positive Response Percent, the average score for patient safety and the CSP index. The hospital with the highest improvement was the state followed by federal and private, it shows that PNSP was an inducer of improving of services in Brazil, since this order was reversed culture level before PNSP. Conclusion: This study shows a consistent improvement of CSP in hospitals after PNSP, pointing to the effectiveness of external national regulation, which in turn appear to be modulated by the variability of the internal context.
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